False-positive cerebrospinal fluid cryptococcus antigen in Libman-Sacks endocarditis.

Background: Cryptococcus meningoencephalitis is a serious opportunistic infection associated with high morbidity and mortality in immunocompromised hosts, particularly patients with advanced AIDS disease. The diagnosis is established through cerebrospinal fluid (CSF) cryptococcus antigen detection a...

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Publicado en:Infection Vol. 44; no. 6; pp. 803 - 806
Autores principales: Isseh, Iyad, Bourgi, Kassem, Nakhle, Asaad, Ali, Mahmoud, Zervos, Marcus
Formato: case study Journal Article
Publicado: Springer Nature Dec2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2016
      vid: 44
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-016-0909-8
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        atl: False-positive cerebrospinal fluid cryptococcus antigen in Libman-Sacks endocarditis.
      aug:
        au:
          Isseh, Iyad
          Bourgi, Kassem
          Nakhle, Asaad
          Ali, Mahmoud
          Zervos, Marcus
        affil: Department of Internal Medicine , Henry Ford Hospital , 2799 W Grand Blvd Detroit 48202 USA
      sug:
        subj:
          Cerebrospinal Fluid Analysis
          False Positive Results
          Cryptococcus Analysis
          Lupus Erythematosus, Systemic
          Antigens, Fungal Analysis
          Endocarditis Diagnosis
          Autoantibodies
          Middle Age
          Female
          Confusion Etiology
          Magnetic Resonance Imaging
          Anticoagulants Administration and Dosage
          Endocarditis Drug Therapy
          Echocardiography, Transesophageal
          Ischemia Diagnosis
          Thromboembolism Diagnosis
          Middle Aged: 45-64 years
          Female
      ab: Background: Cryptococcus meningoencephalitis is a serious opportunistic infection associated with high morbidity and mortality in immunocompromised hosts, particularly patients with advanced AIDS disease. The diagnosis is established through cerebrospinal fluid (CSF) cryptococcus antigen detection and cultures. Cryptococcus antigen testing is usually the initial test of choice due its high sensitivity and specificity along with the quick availability of the results. Case report: We hereby report a case of a false-positive CSF cryptococcus antigen assay in a patient with systemic lupus erythematosus presenting with acute confusion. While initial CSF evaluation revealed a positive cryptococcus antigen assay, the patient's symptoms were inconsistent with cryptococcus meningoencephalitis. A repeat CSF evaluation, done 3 days later, revealed a negative CSF cryptococcus antigen assay. Conclusion: Given the patient's active lupus disease and the elevated antinuclear antibody titers, we believe that the initial positive result was a false positive caused by interference from autoantibodies.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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